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WHO’s list of tests could lead to effective medical care in India, say experts

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Doctors say list could help streamline tests and improve disease diagnosis, but warn implementation could be problem in over-populated environment.

New Delhi: The World Health Organization’s (WHO) list of in vitro diagnostic tests underlined as essential for the health sector worldwide has been welcomed by doctors in India, who feel it could boost effective medical care in the country. They, however, expressed reservations on the implementation of such a list in an over-populated environment.

The WHO lists around 103 diagnostic tests, which it hopes will be a guideline for healthcare systems around the world.

Some 58 of the tests on the list, published on May 16, include routine ones such as blood and urine tests, measurements of red and white blood cells, blood sugar and liver enzymes, plus tests for one-time events like pregnancy or transfusion blood-typing.

The remaining 55 are tests for diseases that WHO considers should be accorded the highest priority: HIV, tuberculosis, malaria, hepatitis B, hepatitis C, HPV and syphilis.

‘Will lead to better diagnosis’

“The list should help at different levels of health care facilities, mainly the primary and secondary health care services of the government. The initial tests would be effective, leading to diagnosis of disease at the early stages. This will foster timely treatment,” Dr Rajendra Sharma, medical superintendent, Safdarjung Hospital, told The Print.

Sharma says the recommendation will benefit the country as the agency must have considered all the “developing and under-developed” countries and their requirements before making this list essential. “It must be a basic standard facility to give good healthcare.”

With a chain of private laboratories in the country, experts say patients are often exploited in private set-ups. Thus, instead of going for a battery of tests, a focused list could yield good results in early and correct diagnostics.

“Unfortunately, our system is unorganised. Every nook and corner has a pathology lab that has different charges for the tests. A battery of tests and packages are being offered where patients suffer. If such a list has been made essential, it will be effective,” head of Department of Internal Medicine, Sir Ganga Ram Hospital Dr S.P. Byotra told ThePrint. He, however, said that implementing the recommendations in a country as large as ours could be a challenge in itself.

“It’s good but I am not sure if it will be feasible. Every place in India is not Delhi and Mumbai thus it’s important to create awareness. If we are able to sort it then both government and private should be involved. Question is whether we will be able to implement it or not?” Byotra asked.

The Delhi government has entered into a public-private partnership under which patients are referred to private labs for tests not available at government hospitals due to rush or unavailability of facility.

“We already have an exhaustive list of diagnostic tests. Whether a list recommended by WHO could be made mandatory is policy decision that should come from the government. We are depending on tertiary care. We have expanded to Mohalla clinics and depending on hospitals we send patients to private partners for tests free of cost. Our only challenge is numbers, we are overcrowded,” said Dr Punita Mahajan, medical superintendent, Baba Saheb Ambedkar Hospital in North West Delhi.

Source: NYT

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